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Alzheimer’s Disease

October 1, 2008

It is very important to understand the difference between the general forgetfulness that often accompanies old age and the onset of Alzheimer’s. It is perfectly normal for older people to exhibit forgetfulness and mild forms of some of the other symptoms of Alzheimer’s. This does not in any way mean that they are in the early stages of the onset of Alzheimer’s, or that they will go on to develop a full-blown, extreme case of Alzheimer’s. In addition, many other conditions can cause Alzheimer’s like symptoms. A diagnosis from a professional medical doctor is the only way to be sure.

We want to provide information to people who are interested in learning more about Alzheimer’s Disease, or who may be worried about the possible onset of Alzheimer’s, or the friends, family, or relatives of those who might suffer or be at risk of suffering from Alzheimer’s

Many Alzheimer’s patients experience agitation in addition to memory loss. In the early stages of the illness, people with Alzheimer’s may encounter changes in their personality, such as irritability, anxiety or even depression. But as the disease progresses, these symptoms can worsen and become more difficult to live with. They may include sleep disturbances, delusions and hallucinations. Many times Alzheimer’s patients cannot get in touch with or express their feelings. So when they experience agitation, it is often difficult for the caregivers to understand and to help.

What is agitation?

  • Extreme emotional disturbance. (The American Heritage Dictionary of the English Language)
  • A stirring up or arousing; disturbance of tranquility; disturbance of mind that shows itself by physical excitement. (Webster’s Revised Unabridged Dictionary).
  • A mental state of extreme emotional disturbance, the feeling of being agitated; not calm.

When a person with dementia displays agitation or other “symptoms,” you must try to determine what they are trying to communicate. Good communication is an important part of any relationship. When caring for a person with dementia, the ability to communicate becomes more and more difficult. Both expressing and processing information becomes impaired. This inability to express and process can be frustrating and can manifest itself as agitation. Following are some suggestions that may allow you to improve your communication with your loved one who has Alzheimer’s:

  • Approach from the front to prevent startling him or her.
  • Maintain eye contact.
  • Lower the tone of your voice. A high pitch may indicate that you are upset.
  • Smile and be pleasant.
  • Talk with a calm presence.
  • Speak slowly, clearly and directly.
  • Identify yourself. Use short, simple sentences.
  • Ask one question at a time.
  • Eliminate background noise.
  • Give plenty of time to respond.
  • If he/she cannot find words, sometimes it helps if you finish the sentence.
  • Repeat information when needed – repetition is good.
  • Frequently affirm/praise him/her, even for the smallest things, i.e. “Good job,” “Thank you,” “You’re the best!” Validate feelings.
  • Use touch. Touch the shoulder, knee, back, hand.
  • Give hugs many times a day.
  • Don’t argue – you’ll never win.
  • Laugh together.
  • If your talk becomes “heated,” stop. Go back and try again later.
  • Don’t talk down. Respect him/her as an adult.
  • Don’t’ correct him/her.
  • Don’t demand. Ask nicely.
  • Don’t take adverse behavior personally.
  • Slow down! Hurrying increases frustration.

Another issue in agitation is non-verbal communication. Non-verbal communication is important to be aware of, both in what we are communicating to our loved ones, and what they are communicating to us. Non-verbal communication is expressed by persons with dementia through body languages, facial expression and tone of voice. At times, the Alzheimer’s patient can look into your eyes and seem to read your soul, almost like a “sixth sense.” They are sensitive and intuitive to people and things around them. They know when someone is being sincere or not. Body language is as important as their facial expressions. For example, if your loved one suddenly gets up and walks around, that may indicate the need to go the bathroom. Be alert to those signs and give big hugs as much as possible. A gentle touch will make their life much easier and relaxed. Environment can also cause agitation. Examples would be where temperatures are too cold or too hot, or lights too strong or too dim. Try to set up an environment that is relaxing for your loved one. It will make his or her life easier. And as your loved one with Alzheimer’s relaxes, so will you.

It is important having an ID for Alzheimers: “Keeping these people safe is a continuous concern for their care-givers. Beside ID, the Alzheimer Association offers these steps to protect our loved ones on a daily basis.

  • Make potentially dangerous places less accessible
  • Lock or disguise hazardous areas.
  • Install door locks out of sight.
  • Use special safety devices, such as child-proof locks and door knobs, to limit access to places where knives, appliances, equipment, and cleaning fluids are stored. Accommodate for visual changes
  • Diffuse bright light by removing or covering mirrors and glass-top furniture, and cover windows with blinds, shades, or sheer draperies.
  • Add extra lighting in entries, outside landings, areas between rooms, stairways, and bathrooms because changes in levels of light can be disorienting.
  • Place contrasting colored rugs in front of doors or steps to help the individual anticipate staircases and room entrances.Avoid injury during daily activities.
  • Monitor the temperature of water faucets and food because the person may have a decreased sensitivity to temperature.
  • Install walk-in showers, grab bars, and decals to slippery surfaces in the bathroom to prevent falls.
  • Supervise the person in taking prescription and over-the-counter medications. Beware of hazardous objects and substances.
  • Limit the use of certain appliances and equipment such as mixers, grills, knives, and lawnmowers.
  • Supervise smoking and alcohol consumption.
  • Remove objects, such as magazine racks, coffee tables, and floor lamps, to create safe wandering areas and reduce the possibility of injury.
  • Clean out the refrigerator regularly and discard inedible food.
  • Lock firearms in a cabinet or drawer, or remove them from the house.
  • Don’t allow unsupervised access to firearms. Be prepared for emergencies.
  • Keep a list of emergency phone numbers and addresses for local police and fire departments, hospitals, and poison control help lines.
  • Check fire extinguishers and smoke alarms, and conduct fire drills regularly.

    • Caring for an Alzheimer’s patient can be a huge burden. When it
    becomes too hard and too time consuming for you to take care of
    your loved one, it may be time to look for a nursing home.

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